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MMPI indices of childhood trauma among 110 female outpatients.

This study investigated MMPI characteristics of adult female outpatients in a behavior therapy clinic (N = 110). Those reporting histories of childhood sexual or physical abuse or both differed from those who did not on global Minnesota Multiphasic Personality Inventory (MMPI; Hathaway & McKinley, 1943) indices of psychopathology and on Scales F, K, L, 4, 7, and 8. Subjects reporting abuse also reported high rates of other early traumas: witnessing family violence, parental alcohol abuse, and parental divorce. Physical abuse history was the best predictor of adult maladjustment as assessed by the MMPI. Findings suggest the potential utility of the MMPI for assessing long-range trauma effects and highlight the importance of considering multiple early-risk factors for the development of psychological disturbance.

Adjustment Disorders↗

Comparative validity of MMPI-2 and MCMI-II personality disorder classifications.

Minnesota Multiphasic Personality Inventory-2 (MMPI-2) overlapping and nonoverlapping scales were demonstrated to perform comparably to their original MMPI forms. They were then evaluated for convergent and discriminant validity with the Million Clinical Multiaxial Inventory-II (MCMI-II) personality disorder scales. The MMPI-2 and MCMI-II personality disorder scales demonstrated convergent and discriminant coefficients similar to their original forms. However, the MMPI-2 personality scales classified significantly more of the sample as Dramatic, whereas the MCMI-II diagnosed more of the sample as Anxious. Furthermore, single-scale and 2-point code type classification rates were quite low, indicating that at the level of the individual, the personality disorder scales are not measuring comparable constructs. Hence, each instrument is providing similar and unique information, justifying their continued use together for the purpose of diagnosing personality disorders.

Adult↗

Future directions for the MMPI-A: research and clinical issues.

The Minnesota Multiphasic Personality Inventory-Adolescent (MMPI-A; Butcher et al., 1992), released in 1992, was developed specifically for use with adolescent respondents. The purpose of this article is to offer suggestions concerning 6 areas of productive research with this instrument. These areas include studies of the utility of codetype interpretation, issues related to profile elevation in clinical samples, and the identification of criterion for evaluating the usefulness of traditional and new MMPI-A scales. Further, these research issues also include establishing the optimal age ranges for use with the MMPI-A, detecting the effects of the release of a revised instrument on clinician's test use patterns with adolescents, and evaluating the optimal methods for the use of the MMPI-A Structural Summary interpretative approach. It is noted that these research recommendations are by no means exhaustive, and that many other research areas should also be investigated in developing a comprehensive research literature for this revised instrument.

Forecasting↗

Selected MMPI-2 scales' ability to predict premature termination and outcome from psychotherapy.

Research examining the MMPI's ability to predict premature termination has yielded discrepant findings. This may be due, in part, to previous operational definitions of premature termination and extensive analysis on inadequately sized samples. This study addressed both methodological issues. This study examined MMPI-2 clinical Scales 2, 4, and 7 and content scales DEP, ASP, ANX, and TRT as predictors of premature termination and psychotherapeutic outcome in 86 adult clients seeking services at a university-based clinic. Premature termination was operationalized as therapists' ratings of clients' readiness for termination. Psychotherapeutic outcome was operationalized as therapists' ratings of the clients' progress in therapy goals, improvement in global psychopathology, improvement in current functioning, and global improvement. None of MMPI-2 scales predicted readiness for termination. However, significant associations were found between specific MMPI-2 scales and three of the four outcome ratings, with the content scales emerging as better predictors. The implications of these findings are discussed to help guide future research in this area.

Adolescent↗

Long-term stability of MMPI-A scales.

Adolescents (24 boys, 37 girls) from public school settings were given the MMPI-A on 2 occasions with approximately 1 year between testing sessions. Long-term stability of validity, clinical, content, supplementary, and the new Psychopathology Five scales are examined and correlation coefficients are presented. The reliabilities of the MMPI-A scales are consistent with previously reported data. In addition, improvements made during development of the MMPI-A may have led generally to modest increases in stability of the clinical scales for adolescents. Given the importance of both short-term and long-term test-retest data in the evaluation of the validity of an assessment instrument, this study represents an important step in evaluating the validity of the MMPI-A for assessment of personality.

Adolescent↗

Identifying psychological contributions to chronic pain complaints with the MMPI-2: the role of the K scale.

Although the 1-3/3-1 Minnesota Multiphasic Personality Inventory (MMPI) code type is traditionally interpreted as suggesting that somatic complaints are caused or exacerbated by psychological factors, prior research has raised questions about the validity of this interpretation for chronic pain patients. This study examined alternative strategies for using the MMPI to identify psychological contributions to chronic pain complaints. A sample of 125 chronic pain patients completed the MMPI-2. They were also rated by clinical staff on a set of descriptive statements reflecting psychological features that can contribute to physical complaints. MMPI patterns that are traditionally used to identify these features, such as the 1-3/3-1 code type, were not related to the ratings. A relation was found between scores on the K scale and the ratings, where patients with higher scores on the K scale (T > or = 56) received ratings suggesting less of a psychological contribution to their pain complaints. The implications of the findings for understanding the nature of the K scale are discussed.

Adaptation, Psychological↗

The convergent validity of MMPI and Rorschach scales: an extension using profile scores to define response and character styles on both methods and a reexamination of simple Rorschach response frequency.

Past research indicated the convergence of Rorschach and MMPI scales may be a function of (a) simple Rorschach response frequency (R) or (b) complex response-character styles on both methods. In this study, new criteria were developed for defining the second assumption using F and K from the MMPI and R and Lambda from the Rorschach. Although substantially different from the factor criteria used previously (KS = .45 and .30), the new criteria still produced the expected pattern of correlations among MMPI and Rorschach scales. Averaged across 17 constructs, the new criteria produced strong validity coefficients for patients with similar styles (M composite r = .50), though they were less effective for patients with discordant styles (M composite r = -.27). It was also demonstrated that R by itself does not moderate convergent validity. Rather, statistical modeling with two sets of 300 random samples (a) demonstrated the prior findings related to R were the result of sampling error and (b) supported the general hypothesis that Rorschach and MMPI scales correlate to the extent response-character styles correlate. Implications are considered.

Adolescent↗

Predicting parenting behaviors from Antisocial Practices content scale scores of the MMPI-2 administered during pregnancy.

This article examines the relation between scores on the Antisocial Practices (ASP) content scale of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) and parenting behaviors in a sample of low-income women. During pregnancy, 141 women were administered the MMPI-2 and then placed into 1 of 3 groups: an antisocial, nonclinical, or clinical control group. When their children were 13 and 24 months old, antisocial mothers were observed to be less understanding and more hostile and harsh in their parenting styles than mothers in the other groups. The nonclinical and clinical control groups did not differ on any measures. Other MMPI-2 measures of antisocial behavior were not predictive of harsh parenting styles. These findings support the predictive and construct validity of the ASP content scale of the MMPI-2.

Adolescent↗

Interpretation of a full-information item-level factor analysis of the MMPI-2: normative sampling and nonpathognomonic descriptors.

An exploratory item-level full-information factor analysis was performed on the normative sample for the MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989). This method of factor analysis, developed by Schilling and Bock (Bock & Schilling, 1997) and based on item response theory, works directly with the response patterns and avoids the artifacts associated with phi coefficients and tetrachoric coefficients. Promax rotation of the factor solution organizes the clinical scale items into 10 factors that we labeled Distrust, Self-Doubt, Fitness, Serenity, Rebelliousness, Instrumentality, Irritability, Artistry, Sociability, and Self-Reliance. A comparison was made to the results of Johnson, Butcher, Null, and Johnson (1984), who performed a principal-component analysis on an item set of 550 items from the previous version of the MMPI (Hathaway & McKinley, 1943). Along with version changes and sampling differences, the essential differences between Johnson et al.'s results and ours may be attributed to differences between the Schilling and Bock method, which uses all information in the item responses, and the principal-component analysis, which uses the partial information contained in pairwise correlation coefficients. This study included 518 of the complete 567 items of the MMPI-2, versus Johnson et al.'s retention of 309 of the initially included 550 items of the previous MMPI. The full-information analysis retained all 518 initially included items and more evenly distributed the items over the 10 resulting factors, all sharply defined by their highest loading items and easy to interpret. Sampling effects and factor label considerations are discussed, along with recommendations for research that would validate the clinical utility of the implied scales for describing normal personality profiles. The full-information procedure provides for Bayes estimation of scores on these scales.

Adolescent↗

Effect of symptom information and validity scale information on the malingering of depression on the MMPI-2.

MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) data from college students who were attempting to malinger depression (199 women and 171 men) were compared to MMPI-2 data from students who responded honestly (50 women and 45 men). Mean MMPI-2 scores were compared with analyses of variance, and students' success in malingering depression was evaluated with criteria based on cutting scores for validity indexes and on the clinical scales commonly associated with depression. Students who were given information about the validity scales or about the symptoms of depression were more successful at malingering than students who received no information, indicating that malingerers of depression may be able to elude detection by the MMPI-2 if they are informed about the validity scales or the symptoms of depression.

Adult↗

MMPI-2 in the inpatient assessment of women with eating disorders.

The MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) reveals similar patterns across all Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) eating-disorder diagnoses. In this study, 550 women with eating disorders completed the MMPI-2. The 3 highest mean elevations for all eating-disorder diagnostic groups occurred on the same scales in the same order: 2, 7, and 3. The modal code for all groups was 2-7/7-2. However, multivariate analyses using the 16 validity and clinical scales, as well as the 27 content and supplementary scales, indicated that the MMPI-2 also distinguishes among eating disorders, especially in that patients with restricting anorexia report less psychopathology than other groups. These results are compared with the results of past eating-disorder research that used the older MMPI (Hathaway & McKinley, 1983).

Adolescent↗

Cross-validation of the MMPI-2 in detecting malingered posttraumatic stress disorder.

We attempted to cross-validate findings from a previous study (Elhai, Gold, Sellers, & Dorfman, in press) using a clinical sample of combat-related war veterans to distinguish genuine from malingered posttraumatic stress disorder (PTSD) on the MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989). The MMPI-2 scores of 124 male combat war veterans at the PTSD outpatient treatment program of a Veterans Affairs Medical Center were compared with those of 84 adult college students instructed and trained to malinger PTSD. MMPI-2 overreporting variables examined were F, F-Fb, F-K, F(p), Ds2, O-S, OT, and FBS. A stepwise discriminant analysis identified F. F-Fb, F-K, Ds2, O-S, and OT as the best malingering predictors. A predictive discriminant analysis yielded good hit rates for the model with impressive cross-validation results. We assessed cutting scores for the predictors of the model. We discuss clinical implications for using the MMPI-2 to distinguish malingered PTSD from combat-related PTSD.

Adolescent↗

Convergent validity of alternative MMPI-2 personality disorder scales.

The Morey, Waugh, and Blashfield (1985) MMPI (Hathaway et al., 1989) personality disorder scales provided a significant contribution to personality disorder research and assessment. However, the subsequent revisions to the MMPI and the multiple revisions to the diagnostic criteria sets that have since occurred may have justified comparable revisions to these scales. Somwaru and Ben-Porath (1995) selected a substantially different set of items from the MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) to assess Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) personality disorder diagnostic criteria. In our study, we compared the convergent validity of these alternative MMPI-2 personality disorder scales with respect to 3 self-report measures of personality disorder symptomatology in a sample of 82 psychiatric outpatients. The results suggested that Somwaru and Ben-Porath's scales are as valid as the original Morey et al. scales and might be even more valid for the assessment of borderline, antisocial, and schizoid personality disorder symptomatology.

Adult↗

The effects of MMPI-A T-score elevation on classification accuracy for normal and clinical adolescent samples.

In this investigation we examined the ability of the Minnesota Multiphasic Personality Inventory-Adolescent (MMPI-A; Butcher et al., 1992) to classify accurately both clinical and normal adolescents using 2 different T-score elevation ranges, T > or = 60 and T > or = 65, and using 2 different clinical base rates for the occurrence of psychopathology. A clinical base rate of 50% and 20%, respectively, were created by comparing a clinical sample of 203 adolescent inpatients with cooccurring substance abuse and psychiatric disorders with 2 subsamples from the MMPI-A normative group. These subsamples consisted of 203 adolescents matched for sex and age, and a larger subsample of 1,015 adolescents proportionately matched for sex and age, with the clinical group. Classification accuracy analyses revealed that although clinical base rate did affect the accurate classification of cases, a T-score cutoff of 65 resulted in higher levels of accurate classification overall while minimizing the misclassification of both clinical and normal cases. Implications of these findings for the recommended use of the MMPI-A "gray zone" are presented, and the relative areas of strength and weakness of the MMPI-A are reviewed in the identification and description of psychopathology.

Adolescent↗

The predictive capacity of the MMPI-2 and PAI validity scales and indexes to detect coached and uncoached feigning.

The objective of this study was to examine the relative effectiveness of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and the Personality Assessment Inventory (PAI) validity scales and indexes to detect malingering. Research participants were either informed (coached) or not informed (uncoached) about the presence and operating characteristics of the validity scales and instructed to fake bad on both the MMPI-2 and PAI. The validity scale and index scores produced by these research participants were then compared to those scores from a bona fide sample of psychiatric patients (n = 75). Coaching had no effect on the ability of the research participants to feign more successfully than those participants who received no coaching. For the MMPI-2, the Psychopathology F scale, or F(p), proved to be the best at distinguishing psychiatric patients from research participants instructed to malinger, although the other F scales (i.e., F and Fb) were also effective. For the PAI, the Rogers Discriminant Function index (RDF) was clearly superior to the other PAI fake-bad validity indicators; neither the Negative Impression Management scale nor Malingering Index were effective at detecting malingered profiles in this study. Overall, RDF proved to be marginally superior to F and F(p) in distinguishing MMPI-2 and PAI protocols produced by research participants asked to malinger and psychiatric patients. Both the RDF and the F and F(p) scales, however, were able to increase the predictive capability of one another.

Adult↗

Can sex offenders who minimize on the MMPI conceal psychopathology on the Rorschach?

Rorschach sensitivity to minimization is important in forensic evaluations of sex offenders because these individuals frequently deny psychological problems. To study Rorschach minimization, we divided alleged sex offenders according to whether they minimized on the MMPI (Hathaway & McKinley, 1943) or MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) and compared their Rorschachs on indexes of distress, faulty judgment, interpersonal dysfunction, and cognitive distortions. We predicted there would be no differences between MMPI minimizers and nonminimizers on these indexes and that sex offenders of both groups would show greater psychopathology than normative adult samples. Results indicate that mini- mizers produce normal MMPI clinical profiles but still show evidence of psychopathology on the Rorschach. As predicted, sex offenders showed more Rorschach psychopathology than normative samples. Sex offenders' protocols that contained sexual content also showed perceptual distortions. These findings indicate that the Rorschach is resilient to attempts at faking good and may therefore provide valuable information in forensic settings where intentional distortion is common.

Adult↗

Incremental validity of the MMPI-A content scales in the prediction of self-reported symptoms.

The incremental contribution of the MMPI-A (Butcher et al., 1992) content scales to the prediction of scores on self-report measures of psychopathology was examined in a sample of 62 adolescents in inpatient treatment and 59 adolescents from the community. All participants completed the MMPI-A and a battery of criterion measures. A series of hierarchical regression analyses was conducted in which the MMPI-A clinical and content scales served as the independent variables and the criterion measures as the dependent variables. The content scales were found to have incremental validity beyond the clinical scales in predicting variance in the criterion measures. Similarly, the clinical scales also demonstrated incremental validity over the content scales in making these predictions. Both sets of scales made independent contributions to the prediction of sample membership (clinical vs. nonclinical). Findings suggest that both the clinical and content scales of the MMPI-A make significant contributions to the assessment of adolescents' psychological functioning.

Adolescent↗

Symptom correlates of MMPI-2 scales and code types in a private-practice setting.

The purpose of this study was to determine empirical symptom correlates of MMPI-2 (Butcher et al., 2001) scales for private-practice clients, a very understudied yet important population. We examined the scores of 240 male and 407 female clients on the Clinical scales, Content scales, Supplementary scales, and frequently occurring code types. We used a factor analyzed version of the Adult Clinical scales of the Multiaxial Diagnostic Inventory (Doverspike, 1990) as a criterion measure. The results generally indicated that the symptom correlates for the MMPI-2 scales and code types were quite similar to those that have been previously reported in other outpatient and inpatient settings. We concluded that descriptors of MMPI-2 scales and code types generated in other settings may be used when interpreting MMPI-2 profiles of private-practice clients.

Female↗